Manimalethu Ria, Krishna Senthil, Shafy Shabana Z, Hakim Mohammed, Tobias Joseph D
The Ohio State University College of Medicine, Columbus, OH, USA.
Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
Int J Pediatr Otorhinolaryngol. 2020 Jul;134:110016. doi: 10.1016/j.ijporl.2020.110016. Epub 2020 Mar 20.
Various formulae have been suggested to calculate the appropriate sized endotracheal tube in children. The current study prospectively compares three commonly used formulae for selection of cuffed endotracheal tubes in children.
Patients were randomized to one of three formulae (Duracher, Cole, or Khine) to determine the size of the cuffed endotracheal tube for endotracheal intubation. The fit of the tube was noted and intracuff pressure was measured using a manometer. The postoperative incidence of stridor, throat pain/soreness, and hoarseness was noted in the post-anesthesia care unit at 2, 4 and 24 h after the procedure.
The study cohort included 135 patients less than or equal to 8 years, equally divided into three groups based on age, weight, and gender. There was no difference in the intracuff pressure, the volume required to seal the airway, or the number of times in which the intracuff pressure was greater than or equal to 20 or 30 cm HO among the three groups. Six tube changes were required in the Cole group while no tube changes were required in the Duracher group (p < 0.05). The postoperative incidence of adverse events (throat pain, hoarseness, and stridor) at 0-2 h, 2-4 h, and 24 h was higher in the Cole group when compared to the Duracher group.
When using an endotracheal tube with a polyurethane cuff, the Duracher formula provided the best estimate for choosing the correct size.
已提出多种公式来计算儿童合适尺寸的气管内导管。本研究前瞻性地比较了三种常用的儿童带套囊气管内导管选择公式。
将患者随机分为三个公式组（杜拉赫尔公式、科尔公式或基内公式）之一，以确定气管插管时带套囊气管内导管的尺寸。记录导管的适配情况，并使用压力计测量套囊内压力。在术后护理单元，于术后2小时、4小时和24小时记录喘鸣、咽痛/咽喉痛和声音嘶哑的术后发生率。
研究队列包括135名年龄小于或等于8岁的患者，根据年龄、体重和性别平均分为三组。三组之间在套囊内压力、密封气道所需的容积或套囊内压力大于或等于20或30cmH₂O的次数方面没有差异。科尔组需要更换6次导管，而杜拉赫尔组无需更换导管（p<0.05）。与杜拉赫尔组相比，科尔组在术后0 - 2小时、2 - 4小时和24小时不良事件（咽痛、声音嘶哑和喘鸣）的发生率更高。
当使用带有聚氨酯套囊的气管内导管时，杜拉赫尔公式为选择正确尺寸提供了最佳估计。
